Cleveland Clinic Abu Dhabi-1684858034273
The heart transplant was conducted at Cleveland Clinic Abu Dhabi. Image Credit: Supplied

Abu Dhabi: Cleveland Clinic Abu Dhabi, part of the M42 group, has successfully conducted a complex heart transplant for Muhammad Al Ketbi, suffering from familial cardiomyopathy.

The 28-year-old Emirati patient, who had been suffering with heart disease for more than a decade, developed multi-organ failure, and was initially placed on an extracorporeal membrane oxygenation (an external pump for their heart).

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Al Ketbi later needed to be placed on two separate pumps, one for the right and one for the left side of the heart, known as a biventricular assist device (BiVAD). For four months, he was on a BiVAD to stabilise his condition while awaiting a suitable donor for a heart transplant. This landmark case is the first in the UAE where the patient has successfully undergone the three sequential stages of treatment.

Al Ketbi was first transferred to Cleveland Clinic Abu Dhabi in a state of cardiogenic shock. Following a thorough assessment, the medical team found debilitating fluid accumulation in his lungs and abdomen. The multidisciplinary team of physicians intervened immediately to drain the fluid in his abdomen, which resulted in an improvement in his breathing.

Explaining the complexity of the case, Dr. Nadya Almatrooshi, staff physician for cardiology in advanced heart failure and transplant within the Heart, Vascular & Thoracic Institute at Cleveland Clinic Abu Dhabi, said, “When the patient came to us, his condition was very severe. He could not even lie down and was having severe difficulty breathing. We learnt from his previous care team that he had stopped responding to medication. He was therefore admitted to the Intensive Care Unit (ICU) at Cleveland Clinic Abu Dhabi for close monitoring. However, his condition continued to deteriorate, affecting his liver and kidneys.”

It was clear that a heart transplant was imminent, but with multi-organ failure, his condition was unstable. He was placed on extracorporeal membrane oxygenation (ECMO) support, which provided cardiac and respiratory assistance.

“In order to prepare him for the transplant, we had to improve his strength and overall condition. Our multidisciplinary team of physicians determined that installing a BiVAD, two implantable pumps that ensure blood circulation, would help reverse his kidney and liver failure, and present the best chance to help Muhammad as he awaited a suitable donor heart,” explained Dr. Mitesh Badiwala, staff physician for cardiothoracic surgery in the Heart, Vascular & Thoracic Institute of Cleveland Clinic Abu Dhabi.

Al Ketbi remained in the ICU on BiVAD, where his condition improved with nutrition and physical therapy, in time for surgery, when a heart compatible with his age and weight was found.

Dr. Feras Bader, section head for Heart Failure and Transplantation in the Heart, Vascular & Thoracic Institute of Cleveland Clinic Abu Dhabi, said, “During this challenging procedure, the BiVAD was removed, and the donor heart was transplanted. The entire process took approximately six hours and was carried out smoothly with the support of our experts from various subspecialties, including cardiothoracic surgery, anesthesia, cardiac intensive care, nursing, pharmacy, and other areas to provide world-class care.”

Five days after the procedure, Al Ketbi’s condition improved and he was moved out of the ICU to a cardiology ward. It was there that his care team explained the need to adhere to a regimen of immunosuppressants to ensure that his body did not reject the transplanted heart. A week later, he was finally discharged with advice to follow up regularly with Cleveland Clinic Abu Dhabi’s Transplant Centre.

Al Ketbi, who is now living a normal life, expressed immense gratitude to his caregivers, “My family and I are extremely grateful for the high standards of care I received at Cleveland Clinic Abu Dhabi, which has been made possible through the vision of our wise leadership. It was a tremendous blessing to be able to undergo a heart transplant so close to home, surrounded by my family and friends. I am also thankful to my medical team, who monitored my health and well-being closely during a four-month stay at the ICU, and then gave me a new lease on life with a heart transplant.”